title: The neuroanatomy of subthreshold depressive symptoms in Huntington's disease: a combined diffusion tensor imaging (DTI) and voxel-based morphometry (VBM) study.
abstract: BACKGROUND
  Depressive symptoms are prominent psychopathological features of Huntington's disease (HD), making a negative impact on social functioning and well-being.
  
  
  METHODS
  We compared the frequencies of a history of depression, previous suicide attempts and current subthreshold depression between 61 early-stage HD participants and 40 matched controls. The HD group was then split based on the overall HD group's median Hospital Anxiety and Depression Scale-depression score into a group of 30 non-depressed participants (mean 0.8, s.d. = 0.7) and a group of 31 participants with subthreshold depressive symptoms (mean 7.3, s.d. = 3.5) to explore the neuroanatomy underlying subthreshold depressive symptoms in HD using voxel-based morphometry (VBM) and diffusion tensor imaging (DTI).
  
  
  RESULTS
  Frequencies of history of depression, previous suicide attempts or current subthreshold depressive symptoms were higher in HD than in controls. The severity of current depressive symptoms was also higher in HD, but not associated with the severity of HD motor signs or disease burden. Compared with the non-depressed HD group DTI revealed lower fractional anisotropy (FA) values in the frontal cortex, anterior cingulate cortex, insula and cerebellum of the HD group with subthreshold depressive symptoms. In contrast, VBM measures were similar in both HD groups. A history of depression, the severity of HD motor signs or disease burden did not correlate with FA values of these regions.
  
  
  CONCLUSIONS
  Current subthreshold depressive symptoms in early HD are associated with microstructural changes - without concomitant brain volume loss - in brain regions known to be involved in major depressive disorder, but not those typically associated with HD pathology.
authors.affiliation: Department of Neurology,University of Ulm,Ulm,Germany.
authors.forename: R
authors.initials: R
authors.lastname: Sprengelmeyer
authors.affiliation: Department of Neurology,University of Ulm,Ulm,Germany.
authors.forename: M
authors.initials: M
authors.lastname: Orth
authors.affiliation: Department of Neurology,University of Ulm,Ulm,Germany.
authors.forename: H-P
authors.initials: HP
authors.lastname: Müller
authors.affiliation: Centre for Psychosocial Medicine, Department of General Psychiatry,University of Heidelberg,Heidelberg,Germany.
authors.forename: R C
authors.initials: RC
authors.lastname: Wolf
authors.affiliation: Department of Psychiatry,University of Ulm,Ulm,Germany.
authors.forename: G
authors.initials: G
authors.lastname: Grön
authors.affiliation: Centre for Psychosocial Medicine, Department of General Psychiatry,University of Heidelberg,Heidelberg,Germany.
authors.forename: M S
authors.initials: MS
authors.lastname: Depping
authors.affiliation: Department of Neurology,University of Ulm,Ulm,Germany.
authors.forename: J
authors.initials: J
authors.lastname: Kassubek
authors.affiliation: Institut du Cerveau et de la Moelle épinière, Pitié-Salpêtrière Hospital,Pierre and Marie Curie University (UPMC),Paris,France.
authors.forename: D
authors.initials: D
authors.lastname: Justo
authors.affiliation: Department of Neurodegenerative Disease, Institute of Neurology,University College London,London,UK.
authors.forename: E M
authors.initials: EM
authors.lastname: Rees
authors.affiliation: Department of Neurodegenerative Disease, Institute of Neurology,University College London,London,UK.
authors.forename: S
authors.initials: S
authors.lastname: Haider
authors.affiliation: Department of Neurodegenerative Disease, Institute of Neurology,University College London,London,UK.
authors.forename: J H
authors.initials: JH
authors.lastname: Cole
authors.affiliation: Department of Neurodegenerative Disease, Institute of Neurology,University College London,London,UK.
authors.forename: N Z
authors.initials: NZ
authors.lastname: Hobbs
authors.affiliation: Department of Neurology,Leiden University Medical Centre,Leiden,The Netherlands.
authors.forename: R A C
authors.initials: RA
authors.lastname: Roos
authors.affiliation: Institut du Cerveau et de la Moelle épinière, Pitié-Salpêtrière Hospital,Pierre and Marie Curie University (UPMC),Paris,France.
authors.forename: A
authors.initials: A
authors.lastname: Dürr
authors.affiliation: Department of Neurodegenerative Disease, Institute of Neurology,University College London,London,UK.
authors.forename: S J
authors.initials: SJ
authors.lastname: Tabrizi
authors.affiliation: Department of Neurology,University of Ulm,Ulm,Germany.
authors.forename: S D
authors.initials: SD
authors.lastname: Süssmuth
authors.affiliation: Department of Neurology,University of Ulm,Ulm,Germany.
authors.forename: G B
authors.initials: GB
authors.lastname: Landwehrmeyer
mesh_terms: D000328:Adult; D002531:Cerebellum / Q000473:pathology*; D002540:Cerebral Cortex / Q000473:pathology*; D003863:Depression / Q000209:etiology / Q000473:pathology*; D056324:Diffusion Tensor Imaging / Q000379:methods; D006801:Humans; D006816:Huntington Disease / Q000150:complications / Q000473:pathology* / Q000503:physiopathology; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D012720:Severity of Illness Index; D013406:Suicide, Attempted